PT  - JOURNAL ARTICLE
AU  - Andrew Hill
AU  - Dzintars Gotham
AU  - Joseph Fortunak
AU  - Jonathan Meldrum
AU  - Isabelle Erbacher
AU  - Manuel Martin
AU  - Haitham Shoman
AU  - Jacob Levi
AU  - William G Powderly
AU  - Mark Bower
TI  - Target prices for mass production of tyrosine kinase inhibitors for global cancer treatment
AID  - 10.1136/bmjopen-2015-009586
DP  - 2016 Jan 01
TA  - BMJ Open
PG  - e009586
VI  - 6
IP  - 1
4099  - http://bmjopen.bmj.com/content/6/1/e009586.short
4100  - http://bmjopen.bmj.com/content/6/1/e009586.full
SO  - BMJ Open2016 Jan 01; 6
AB  - Objective To calculate sustainable generic prices for 4 tyrosine kinase inhibitors (TKIs).Background TKIs have proven survival benefits in the treatment of several cancers, including chronic myeloid leukaemia, breast, liver, renal and lung cancer. However, current high prices are a barrier to treatment. Mass production of low-cost generic antiretrovirals has led to over 13 million people being on HIV/AIDS treatment worldwide. This analysis estimates target prices for generic TKIs, assuming similar methods of mass production.Methods Four TKIs with patent expiry dates in the next 5 years were selected for analysis: imatinib, erlotinib, lapatinib and sorafenib. Chemistry, dosing, published data on per-kilogram pricing for commercial transactions of active pharmaceutical ingredient (API), and quotes from manufacturers were used to estimate costs of production. Analysis included costs of excipients, formulation, packaging, shipping and a 50% profit margin. Target prices were compared with current prices. Global numbers of patients eligible for treatment with each TKI were estimated.Results API costs per kg were $347–$746 for imatinib, $2470 for erlotinib, $4671 for lapatinib, and $3000 for sorafenib. Basing on annual dose requirements, costs of formulation/packaging and a 50% profit margin, target generic prices per person-year were $128–$216 for imatinib, $240 for erlotinib, $1450 for sorafenib, and $4020 for lapatinib. Over 1 million people would be newly eligible to start treatment with these TKIs annually.Conclusions Mass generic production of several TKIs could achieve treatment prices in the range of $128–$4020 per person-year, versus current US prices of $75161–$139 138. Generic TKIs could allow significant savings and scaling-up of treatment globally, for over 1 million eligible patients.